Human papillomavirus

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Human papillomavirus

Pathology

Pigmented skin disorders

Vitiligo

Albinism

Acneiform skin disorders

Acne vulgaris

Folliculitis

Rosacea

Hidradenitis suppurativa

Papulosquamous and inflammatory skin disorders

Contact dermatitis

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Psoriasis

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Keratotic skin disorders

Actinic keratosis

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Desquamating skin disorders

Erythema multiforme

Stevens-Johnson syndrome

Skin integrity disorders

Pressure ulcer

Sunburn

Burns

Frostbite

Skin infections

Cellulitis

Erysipelas

Impetigo

Necrotizing fasciitis

Human papillomavirus

Varicella zoster virus

Poxvirus (Smallpox and Molluscum contagiosum)

Coxsackievirus

Herpes simplex virus

Candida

Malassezia (Tinea versicolor and Seborrhoeic dermatitis)

Pediculus humanus and Phthirus pubis (Lice)

Sarcoptes scabiei (Scabies)

Human herpesvirus 6 (Roseola)

Parvovirus B19

Varicella zoster virus

Measles virus

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Skin neoplasms

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Human herpesvirus 8 (Kaposi sarcoma)

Angiosarcomas

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Hair and nail disorders

Alopecia areata

Telogen effluvium

Onychomycosis

Integumentary system pathology review

Pigmentation skin disorders: Pathology review

Acneiform skin disorders: Pathology review

Papulosquamous and inflammatory skin disorders: Pathology review

Vesiculobullous and desquamating skin disorders: Pathology review

Bacterial and viral skin infections: Pathology review

Skin cancer: Pathology review

Viral exanthems of childhood: Pathology review

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Human papillomavirus

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Human papillomavirus

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USMLE® Step 1 style questions USMLE

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A 22-year-old woman comes to the clinic to evaluate perianal pruritus and genital lesions. Two months ago, she was diagnosed with acute cervicitis due to Neisseria gonorrhoeae and treated with outpatient antibiotics. She is sexually active and began a monogamous relationship with a new male partner three months ago. They use condoms inconsistently. The patient has had five sexual partners in her lifetime.  Temperature is 37.0°C (98.6°F), pulse is 90/min, respirations are 20/min, and blood pressure is 120/75 mmHg. The abdomen is soft and nontender. External genital examination reveals several smooth, verrucous, skin-colored lesions over the labia majora and minora. Cervical motion tenderness is absent on bimanual examination. Which of the following describes the microorganism most likely responsible for this patient’s symptoms?

External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Human papillomavirus 6 (HPV-6) p. 180

Human papillomavirus 10 (HPV-10) p. 180

Human papillomavirus 14 (HPV-14) p. 697

Human papillomavirus (HPV)

cervical pathology p. 669

HIV-positive adults p. 174

as oncogenic microbe p. 223

penile cancer p. 675

tumor epidemiology p. 667

verrucae p. 489

warts p. 161

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Evan Debevec-McKenney

Human papillomaviruses, or HPV for short, are a group of non-enveloped DNA viruses that specifically infect human epithelial cells.

There are over 100 different types of HPVs which can be categorized by the epithelial cells they prefer to infect; like cutaneous epithelial cells of the skin, especially the face, hands and feet; and epithelial cells of mucous membranes, especially the respiratory tract including the pharynx, and nasal and oral cavities; and anal and genital regions.

Some types can cause benign tumors, called papillomas or warts; and some can lead to carcinomas, or cancer of the epithelial cells.

HPV may have contributed to both actor Michael Douglas’s throat cancer diagnosis, and former first lady of Argentina, Eva Perón’s fatal cervical cancer.

Epithelial cells line the outer surfaces of organs and blood vessels and separate the interior of the body from the external world.

They primarily serve as a protective barrier to invasion by pathogenic bacteria, fungi, parasites and viruses; and to water loss.

In locations like the skin, anus, genitals, and respiratory tract, they can be stratified, having more than one layer of epithelial cells.

At the base, the layer closest to the interior of the body, these cells are less mature, rounded stem cells, also called basal cells.

Basal cells divide and replenish all the cells found in the epithelium.

As the basal cells divide and mature, they move toward the outermost layer, flattening out and becoming more squamous shaped in appearance.

Once they reach the top layer, these mature, flat cells are exfoliated, or shed, from the epithelium.

Now, typically basal cells are well protected under all those layers.

But if there are abrasions or cuts in the epithelium, HPV can gain access to and infect the basal cells.

Once that happens, HPV can replicate with or without being incorporated into the basal cell’s DNA through the activities of two particular viral genes called E6 and E7.

The proteins of these genes cause dysregulation of tightly-scheduled replication of the epithelial cells by altering the p53 and retinoblastoma protein (pRB) tumor suppressor pathways that typically prevent unregulated growth of the epithelial cells.

Elsevier

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